La. Admin. Code tit. 56, § I-119 - Water Well Registration (Short Form)
A. The Water Well Registration Short Form
(DNR-GW-1S) and detailed instructions for properly completing and distributing
the form are available by contacting department staff at (225) 342-8244 or by
accessing the department's website at www.dnr.louisiana.gov/gwater. A copy
is to be mailed, or delivered by an Office of Conservation approved electronic
delivery system, by the water well contractor within 30 days after the well has
been completed. If by mail, send to:
Department of Natural Resources
Office of Conservation
P.O. Box 94275
Baton Rouge, LA 70804-9275
B. A copy of the form shall be retained by
the water well contractor for their files and another copy shall be given to
the well owner immediately upon completion of the work. The commissioner will
consider and encourages the electronic submission of registration, data or
reports required under this section.
C. Although most of the information needed to
complete the form is available to the water well contractor, the following
explanation will provide clarification of intent for selected items and
uniformity of reporting:
1. Use of Well. The
principal purpose for which the well is used should be indicated by checking
the appropriate box on the form. If the well is used for more than one purpose,
only the principal or primary use should be shown.
a. Domestic Well. A water well used
exclusively to supply the household needs of the owner/lessee and his family.
Uses may include drinking, cooking, washing, sanitary purposes, lawn and
garden, watering and caring for pets.
b. Rig Supply Well. A water well drilled at
an oil or gas drilling site to supply water for drilling and/or other field
related activities.
c. Monitoring
Well. A well used to obtain hydrologic and water quality data, usually
installed at or near a known or potential source of ground water
contamination.
d. Heat Pump Supply.
A water well which supplies ground water to a heat pump heat
exchanger.
e. Heat Pump Hole. A
hole drilled to install piping (tubing) material for an earth-coupled water
source heat pump system, also known as a vertical closed-loop system.
f. Abandoned Pilot Hole. A hole drilled with
the intent to install casing and to produce water but had to be abandoned
because of problems related to drilling operations or encountering
unsatisfactory formations.
g.
Other. A well used for a purpose that does not fit into either the above
categories or those requiring a long form (DNR-GW-1).
2. Owner Information. List the name of the
legal owner of the property on which the well is located or the person or
company holding a long-term lease on the property. If the owner or lessee is an
individual, list first and last names and middle initial of individual. List
area code and telephone number of owner in the spaces provided.
3. Owner's Address. List full and correct
address of the owner.
4. Owner's
Well Number. List name or number the well owner has assigned to the
well.
5. Well Information. List in
appropriate spaces, completion date of well, depth of hole, depth of well,
static water level, casing type, size and length, screen size, type and length,
the depth to which the casing was cemented, and cementing method
used.
6. Well Location. List the
parish where the well is located, including the nearest town, city, physical
address, etc., and give directions to the well site. The location of the well
should be described in detail and as accurately as possible so that the well
can be easily located by the department's staff or field inspector. Please
include a detailed map or sketch on the back of the original form, or provide a
legible attachment to the original form, showing the location of the well with
reference to roads, railroads, buildings, etc. Use an (X) to indicate location
of the well. Show location of nearest existing well(s), if any nearby, by
making (Os) and approximate distance between wells. If submitting the
registration form by an Office of Conservation approved electronic delivery
system, follow the instructions on the electronic form for including a detailed
location map. Determine the well's Global Positioning System (GPS) location and
record the GPS longitude and latitude coordinates onto the form. For rig-supply
wells, attach a "registered" permit plat (see
§105.I) and for monitoring
wells, complete spaces provided for the section, township and range (see
§105 J)
7. Remarks. This space can be used for
presenting any other information, such as screen openings, pump information,
problems encountered during drilling, name and license number of water-well
subcontractors, method and materials used to seal heat pump hole,
etc.
8. Driller's Log. List in the
space provided a description of the materials encountered and depth as detailed
in the form instructions. If space on front of the form is insufficient,
continue driller's log on reverse side of original form or attach a copy of the
driller's log to the original form to be transmitted to the department. If
submitting the registration form by an Office of Conservation approved
electronic delivery system, follow the instructions on the electronic form for
including the Driller's Log information.
9. Heat Pump Holes. List average depth of
holes and number of holes drilled at the site. Indicate type of tubing material
used by checking appropriate box. Method and materials used to seal holes shall
be stated under item marked "remarks."
10. Abandonment Information. If the well is
new, specify whether or not it replaces an existing well. The water well
contractor is responsible for informing the owner of the well of state
regulations requiring plugging of abandoned wells.
D. After completing the form, list the name
of the water well contracting company and the license number on the spaces
provided. Sign and date the form and mail the original to the department at the
address listed on the form within 30 calendar days after the well has been
completed. The owner's copy shall be given to the owner immediately upon
completion of the work. The contractor's copy shall be retained by the
contractor for his files.
E. If
there are any questions or you need assistance, please call or write to:
Louisiana Department of Natural Resources
Office of Conservation
P.O. Box 94275
Baton Rouge, LA 70804-9275
Phone: (225) 342-8244
Notes
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